Prismasol Injection
NDC Package 24571-113-06

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

Prismasol (magnesium chloride, lactic acid, sodium chloride, and sodium bicarbonate) injection is pRISMASOL and PHOXILLUM solutions are indicated in pediatric and adult patients for use as a replacement solution in Continuous Renal Replacement Therapy (CRRT) to replace plasma volume removed by ultrafiltration and to correct electrolyte and acid-base imbalances. This formulation utilizes a injection delivery system. Marketed by Vantive Us Healthcare Llc, this product is identified by NDC 24571-113 and is authorized under FDA application NDA021703.

Identification & Billing

NDC Package Code
24571-113-06
Package Description
2 BAG in 1 CASE / 5 L in 1 BAG
Product Code
24571-113
11-Digit Billing Format
24571011306
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
Units Per Package
5000 ML

Clinical Specifications

Proprietary Name
Prismasol Bk0/0/1.2
Non-Proprietary Name
Magnesium Chloride, Lactic Acid, Sodium Chloride, And Sodium Bicarbonate
Substance Name
Lactic Acid; Magnesium Chloride; Sodium Bicarbonate; Sodium Chloride
Dosage Form
Injection - A sterile preparation intended for parenteral use; five distinct classes of injections exist as defined by the USP.
Administration Route
Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)
Pharmacologic Class
Usage Information
PRISMASOL and PHOXILLUM solutions are indicated in pediatric and adult patients for use as a replacement solution in Continuous Renal Replacement Therapy (CRRT) to replace plasma volume removed by ultrafiltration and to correct electrolyte and acid-base imbalances. They may also be used in case of drug poisoning when CRRT is used to remove dialyzable substances.

Regulatory & Marketing

Labeler Name
Vantive Us Healthcare Llc
Product Type
Human Prescription Drug
FDA Application #
NDA021703
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
10-25-2006
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 24571-113-06 identifies a specific commercial package of 2 bag in 1 case / 5 l in 1 bag of Prismasol Bk0/0/1.2, a human prescription drug labeled by Vantive Us Healthcare Llc. This product is billed per "ML" milliliter and contains an estimated amount of 5000 billable units per package. This injection is formulated for intravenous use and contains lactic acid; magnesium chloride; sodium bicarbonate; sodium chloride as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Vantive Us Healthcare Llc on October 25, 2006. The current certification is valid through December 31, 2026.

How is this Vantive Us Healthcare Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 24571011306. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. There are 5000 total billable units per package. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
24571-113-06
11-Digit CMS (5-4-2)
24571-0113-06

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.